Alcohol Harm

Liam Byrne Excerpts

Thursday 25th November 2021 Commons Chamber

[Liam Byrne (Birmingham, Hodge Hill) (Lab)]

I am grateful for the chance to contribute to this debate, and I thank the Backbench Business Committee. It is a real privilege to follow the hon. Member for St Ives (Derek Thomas). In my remarks I will speak for myself, but I will also try to say a few words for my hon. Friend the Member for Liverpool, Walton (Dan Carden), who, as was mentioned, is with his family and his father Mike, who is receiving palliative care after treatment for lung cancer. I know I speak for all of us when I say that all our love, prayers and best wishes go to my hon. Friend and his family.

This debate is profoundly important. It is important for many people, such as the hon. Member for St Ives. It is important for many of those who are hon. Members and, like me, children of alcoholics. I am the son and the grandson of alcoholics. I watched those people die from alcohol and I watched how this terrible disease cascades down the generations, causing chaos, pain and distress in its wake. In the all-party children of alcoholics group, which I co-chair, we have come together because we know that we have to try to break the silence in order to break the cycle of the disease cascading down any more generations to come. We know too that we have to normalise the conversation, and that means that we have to help organise the conversation. That is why, for us, this debate is so important.

There are so many people, and so many Members of this House, who are still bound in fear with stigma and shame that stops them speaking out. I have now lost count of the number of our colleagues here who have approached me in the Lobbies and corridors to say, “I too am the child of an alcoholic”, but, for whatever reason, they are not able to speak out. I almost did not speak myself. I did so only through the spiritual guidance of Father Gerry, God rest his soul, at St Chad’s Cathedral in Birmingham, who helped show me that if, by speaking out, I could effect change, then I was doing the right thing: that in fact what I would be doing is honouring the boy that became the man that became my dad. My father was the child of an alcoholic and he had no help available to him. So I hope that this debate encourages more of us in this place to speak out and talk publicly about the things that people have said to me in the Lobbies and the corridors, because we have a wrong to right, and that wrong is that we have no strategy for tackling alcohol harm.

My work on this issue goes back to 2015 and the election of that year. David Cameron, the Prime Minister at the time, was busy waving my famous leaving note at the Treasury. It was something that caused me immense public shame. But what I could not talk about at the time was the intense private shame that I was going through nursing my father in the final days of his life at Princess Alexandra Hospital in Harlow. He died on the morning of St Joseph’s Day. After his death, and after that election, I fell to pieces. It was only through getting in touch with the National Association for Children of Alcoholics that I discovered that I was not alone.

I grew up knowing all the feelings that every child of an alcoholic becomes all too familiar with: trying to make yourself invisible to disappear from the shame of some terrible public incident; the chronic insecurity; the co-dependency of supporting others, in my case, my mother, from the age of eight; the bouts of violence, luckily, in my case, occasional; the hospital visits; and the trouble with ambulances. There is the pervasive sense of guilt. Am I doing enough? Is my father okay? Is he eating? Is he starving? Or is he on a floor somewhere?

There is the drive for perfection: the striving to please someone who does not really seem to care. Not long after I got into the Cabinet—it was a moment of immense pride for me and I wanted to show my dad how proud he should have been of the work that I put in—he came to our office at the Cabinet Office; it is a grand place. He was too drunk to stand. It was utterly humiliating and we had to bundle him out as fast as possible. I came to see that nothing I could do would ever be good enough, and nothing I could do would stop him drinking. Every child of an alcoholic can tell scores of stories just like mine.

Those who helped me process trauma taught me that you have to build an integrated picture of the past with the good and the bad, the light and the dark. For children of alcoholics, the pieces of the puzzle that you try to put together are so sharp that they cut you, and you bleed. That is why support from organisations such as the National Association for Children of Alcoholics is life-changing. It is not just a helpline; it is literally a lifeline. That is why we must do better in putting a strategy in place to combat the harm of alcohol.

I am not sure that I would be here without NACOA’s help, and that is why I say a profound thank you to Hilary Henriques and her team—Piers, and Josh Connolly. I also thank the amazing patrons Calum Best, Tony Adams, Camilla Tominey, David Coldwell, Sophie K, and so many others. I speak for all involved in our movement when I say a profound thanks to Her Royal Highness Princess Catherine for her leadership in supporting Forward Trust and the Action on Addiction alliance of which NACOA is so proud to be a part.

My father was an inspiration to me. He was brilliant, charismatic, a fighter for love and a fighter for decency. But he was in the grips of an addiction for which there was no help. What was true for him is now true of thousands of children. What is so appalling is that one in five children in this country are in that predicament—they are children of parents who drink too much. More than 60% of care applications involve the misuse of alcohol or drugs. Parental alcohol misuse accounts for nearly 40% of cases where a child is killed or seriously injured. Children of alcoholics are more likely to become addicted to alcohol, to develop eating disorders and to take their own lives. That is why we need a strategy to combat the harm of alcohol.

When we started our work in 2016, we discovered that not one local authority had a strategy for children of alcoholics. In our last survey, that had gone up to half—but that means that half do not have strategies in place—and more than 90% of local authorities were cutting budgets for drug and alcohol treatment despite some having rising admissions for alcohol accident and emergency cases. Half of councils saw referrals for alcohol treatment going down, not up, yet we still do not have a strategy for alcohol harm.

My hon. Friend the Member for Liverpool, Walton wanted to make the point that almost three people an hour die of alcohol-related causes. Alcohol-related harms now cost us £27 billion a year. People from the most deprived communities are 60% more likely to die than those in richer communities. Alcohol-specific deaths have soared by more than 20% over the course of lockdown, and 40% of crime is linked to alcohol, yet we still do not have a strategy to combat alcohol-related harm.

To help Ministers, children of alcoholics across the country united to draw up our first manifesto for change, with a simple set of 10 messages therein. It has a beautiful instruction from his grace the Archbishop of Canterbury, himself the child of an alcoholic. We want: to ensure that there is a strategy for children of alcoholics; properly funded local support; better support for families; better education and awareness for children; a plea for the Government to help lead a change of public attitudes; better education and training for those who work with children; minimum alcohol unit pricing; to curtail the promotion of advertising on alcohol; and the Government to take responsibility for reducing rates of alcoholism. We want a strategy for reducing the harm of alcohol.

My hon. Friend the Member for Liverpool, Walton wanted to highlight the points made about minimum alcohol pricing. If he were here, he would have highlighted that in some ciders a unit of alcohol costs just 19p. That means a person can buy the recommended weekly maximum of 14 units for £2.68—less than the price of a cup of coffee. In Scotland and Wales there is minimum unit pricing, which is working—it is driving down addiction rates—and the Government should learn from it. Equally, alcohol advertising needs to be curtailed.

Finally, we thought that under the right hon. Member for South West Surrey (Jeremy Hunt) we were making progress. Funding for the NACOA helpline was put in place, as was funding for pilots. Inexplicably, at a time of surging alcohol misuse, the funding for those programmes has stopped. We assume that that is an error and we look forward to meeting the Secretary of State to talk about reinstating that funding.

We know that we cannot change things for our parents, but we are damn well going to change things for our children. That means campaigning until we get a strategy in place to tackle the harm from alcohol.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

I thank my hon. Friend the Member for St Ives (Derek Thomas) for leading on this important debate. There may not have been too many contributions, but those we have had have been really, really valuable. I am very sorry to hear that the hon. Member for Liverpool, Walton (Dan Carden) cannot be here for this important debate. I send my best wishes to him and his family at this very difficult time.

The majority of people drink alcohol responsibly, but we know that there are people who drink at levels which lead to significant harms. Alcohol misuse can have devastating impacts on individuals, families, communities and society. Over the course of the pandemic, we have seen an increase in those drinking at higher risk levels, and, sadly, an increase in alcohol-specific deaths. I would like to take this moment to commend our frontline workers. They have been tirelessly working and supporting people in need in the most difficult circumstances.

Throughout the pandemic, drug and alcohol treatment providers have continued to support and treat people. To ensure treatment services continue supporting people to the highest standards, we have made the largest increase to treatment funding for substance misuse in 15 years. We have provided £80 million of new investment in 2021-22. Some £9.8 million of that uplift has been allocated specifically to increase the availability of in-patient places for medically assisted withdrawal. That is of critical importance for people heavily dependent on alcohol, where rapid withdrawal can be extremely dangerous. The funding is in addition to the money that local authorities already spend on substance misuse from the public health grant.

The Government have agreed to carry forward the recommendations of part two of Dame Carol Black’s independent review of drugs—my hon. Friend the Member for St Ives talked about Dame Carol Black’s report in his speech—and to publish a new drugs strategy later this year. Although the subject of the review was drugs, the implementation of many of its recommendations will also benefit people seeking treatment for alcohol dependency, for example through the introduction of mechanisms such as an improved commissioning standard and a strong focus on building back the workforce. To further improve alcohol treatment, the Office for Health Improvement and Disparities is developing comprehensive UK guidelines for the clinical management of harmful drinking and alcohol dependence. The guidelines should develop a clear consensus on good practice and improve the quality of service provision.

There is clear evidence that growing up in a family affected by parental alcohol dependency can cause significant harm to a child’s wellbeing and damage their long-term outcomes. Thanks to the personal testimony and campaigning from Members here today—I will respond further to the right hon. Member for Birmingham, Hodge Hill (Liam Byrne) later in my speech—we have invested £7.2 million on a package of measures, over four years, to improve outcomes and support for children whose parents are alcohol dependent. Some £5.7 million of that has funded nine local areas to implement innovative and evidence-informed interventions, and will make system-wide improvements to working holistically with these families. Early findings of the programme indicate positive results, for example in the local areas receiving programme funding, and we have seen improved identification of children in need, and more parents starting alcohol treatment. We are actively considering how we share lessons from the programme nationally, and the implications for future policy and practice. To aid that, we have commissioned an independent national evaluation of the programme, expected to be published in spring 2022.

Alcohol harms are not experienced equally across groups. Despite reporting lower or similar levels of drinking, those of lower socioeconomic status experience disproportionate alcohol-related harm. There are also significant geographical disparities, with the highest rates of mortality from alcohol-specific causes seen in the northern regions.

As part of the long-term plan, we have provided national funding to support the implementation of specialist alcohol care teams in the 25% of hospitals with the highest rates of alcohol dependence-related admissions. It is estimated that the programme will prevent 50,000 admissions over five years.

We are also committed to supporting the most vulnerable in our society. This year, we are delivering up to £52 million for substance misuse treatment services for people sleeping rough, building on the £23 million in 2020-21. That will fund evidence-based drug and alcohol treatment and wraparound support to improve access, including for those with co-occurring mental health needs.

The Government believe that people have a right to accurate information and clear advice about alcohol and its health risks, enabling people to make informed choices about their drinking. As a result, we continue to educate the public, ensuring that people are aware of the health risks of alcohol through local and national programmes, such as the Better Health campaign and the Drink Free Days app.

An alcohol risk assessment is a mandatory component in the NHS health check so that people are given advice on cutting down if their drinking is putting their health at risk. To ensure that people have all the information they need at the point of purchase, we will shortly consult on whether mandatory calorie labelling should be introduced on pre-packed alcohol and alcohol sold in the out-of-home sector. The consultation will also seek views on mandatory provision of the UK chief medical officer’s low-risk drinking guidelines and a drink-drive warning. The hon. Member for Nottingham North (Alex Norris) talked about the impact that drink-driving can have on families. Respondents to that consultation will have the opportunity to provide suggestions for further labelling requirements that they would like the Government to consider.

I will take the opportunity now to address the issues raised during the debate. My hon. Friend the Member for St Ives talked about foetal alcohol spectrum disorder, and I reassure him that we take that very seriously. We have asked NICE to produce a quality standard in England for FASD to help the health and care system to improve the diagnosis and care of those affected, based around the Scottish intercollegiate guidelines network—SIGN 156—standard. To help improve support for those living with its consequences, we have funded five voluntary organisations in 2020-21, and we are analysing the evaluations to be taken into account for further policies on FASD.

The right hon. Member for Birmingham, Hodge Hill shared his moving and personal experiences of being a child and a grandchild of an alcoholic. I thank him for his openness. He talked about stigma and the importance of sharing experiences. I am sure that, by sharing his experience today, he will have made a difference to so many people, and I thank him for that.

The right hon. Gentleman asked about a number of other issues, including the strategy, as the hon. Member for Nottingham North and the hon. Member for Linlithgow and East Falkirk (Martyn Day) did. The Government have committed to publishing a new UK-wide cross-Government addiction strategy, which will focus on creating further opportunities to tackle and address addictions, such as alcohol and drugs as well as gambling-related harms, in a comprehensive and joined-up way. As I said, alcohol and drug addiction are far too often intrinsically linked, and we are committed to tackling that.

[Liam Byrne]

I wonder whether the Minister could share with the House her forecast timeframe for that addiction strategy and, in so doing, perhaps recognise that there are significant differences between addiction to drugs and alcohol, not least because one is legal and the other is illegal.

[Maggie Throup]

I thank the right hon. Gentleman for that intervention. I am sure he will appreciate that Dame Carol Black’s report acknowledged that there are differences, but they are intrinsically linked as well. I fully take his point that one is illegal and the other is illegal, and that will be taken into consideration.

My hon. Friend the Member for St Ives, the right hon. Member for Birmingham, Hodge Hill and the Scottish National party spokesman, the hon. Member for Linlithgow and East Falkirk, talked about the minimum unit price. The Government continue to monitor the impact of the minimum unit price as evidence emerges from Scotland and Wales. Although some evidence has been published by Public Health Scotland relating to the impact of MUP, further important components of the evaluation are not scheduled for release until 2023, including the impact on alcohol-related admissions and deaths.

Another important issue raised in the debate was the relationship between domestic abuse and alcohol addiction. The Domestic Abuse Act 2021 will mean better protections for victims and more effective measures for going after perpetrators. We are reflecting the importance of joined-up domestic abuse, mental health and substance misuse services in supporting statutory guidelines.

Let me briefly address the issue that the hon. Members for Linlithgow and East Falkirk and for Nottingham North raised about amendments that were not made to the Health and Care Bill. Alcohol has not been included in the advertising restrictions in the Bill, mainly because the Government have existing measures in place to protect children and young people from alcohol advertisements. The 2019 and 2020 consultations on advertising restrictions on less healthy food and drink did not consult on including alcohol in the restrictions, either online or on TV. Finally, alcohol products are not available for children to purchase, so they do not have the same level of exposure to them.

In closing, I reiterate the Government’s commitment to supporting those who are most vulnerable to and at risk of alcohol misuse. I am confident that our strong programme of work under way to address alcohol-related harms, the increased funding for treatment providers and the recommendations in Dame Carol Black’s review that we are taking forward will all further support people who are experiencing alcohol dependency and alcohol-related harms, as well as those on whom they have an impact.